OWBC Lightbulb Presentation (October 2018) 02/10/2018 OWBC’s Vision “ A Stronger Borough Together “ Councillors, staff, residents, businesses, partners and stakeholders will continue to create a stronger borough by working together A stronger Borough that is inclusive and engaged and focuses on delivering effective services, balanced economic development, green and safe places resulting in better wellbeing for all. Full Council | Tuesday, 02 October 2018 1
OWBC Lightbulb Presentation (October 2018) 02/10/2018 Background • Housing Offer to Health 2013 • £1m Transformation Challenge Award from DCLG • National and local strategic drivers support the case for Lightbulb service transformation � Areas being encouraged to think strategically about use of home adaptations and technologies through the BCF � Leicestershire’s ageing population; increased demand on services (OWBC 12,000 over 65 rising to 12,600 in 2020*) � Costs to NHS of poor housing, falls and LTC are significant � DFG work can delay the need for residential care and is cost effective but DFG process can be unnecessarily lengthy * Figures provided by Institute of Public Care THE LIGHTBULB OFFER The lightbulb philosophy, offer, operating model and all processes within • it have been co-designed between adult social care, health and all 7 Districts The offer is a targeted, proactive approach including via GPs and other • health/care professionals such as those in integrated locality teams Early assessment and triage of housing issues at key points of entry • Hub and spoke model - integrated locality Lightbulb team in each District • Council area (OWBC has 1FTE Housing Support Coordinator, 0.3Tech Officer, 0.4 Admin , 9% of Locality Hub) Common functions (management, performance, development etc) sit • within the central ‘hub’ Full Council | Tuesday, 02 October 2018 2
OWBC Lightbulb Presentation (October 2018) 02/10/2018 THE LIGHTBULB OFFER • Housing Support Co-ordinator (HSC) role encompasses functions previously carried out across District and County Councils - supported by OT and technical officer expertise (the locality team) • HSC job role include trusted assessor element, supported by competency framework • Customer focussed assessment and solutions through the Housing MOT checklist • Offer supports both step down from hospital and step up in community settings • Integrated working with other key stakeholders such as community fire and rescue/home safety teams also in place Lightbulb Governance –Service Hosted by BDC Management Board (rep from OWBC) Delegation and Delivery Group Collaboration (rep from OWBC) Agreement Lightbulb Team Full Council | Tuesday, 02 October 2018 3
OWBC Lightbulb Presentation (October 2018) 02/10/2018 Housing MOT Personal Safety Other Home Housing MOT Local Security Community Warmth BENEFITS ILLUSTRATION Mr T was discharged from hospital following aortic valve replacement surgery. Mr T’s wife contacted the Customer Service Centre for assistance with bathing: The Previous Journey The Lightbulb Journey Positive customer experience • More handoffs and longer waiting • Holistic assessment included support • time to claim attendance allowance, falls Single issue approach • prevention advice Full Council | Tuesday, 02 October 2018 4
OWBC Lightbulb Presentation (October 2018) 02/10/2018 Evidence of utcomes – Housing support co-ordinators On average each resident benefited from 3 housing support • interventions (excluding advice and signposting) 30 cases were analysed using the NHS number and PI’s Care and • Health Trak tool, this showed a reduction in service usage of 66% Two months post intervention saw adult social care costs reduced • by 23% Scaled up to include all potential Housing Support Co-ordinator • cases, this could lead to cost savings of up to £250,000 to Adult Social Care per year 18 cases analysed where residents had previously fallen. 17 • reported no falls since they received their interventions A reduction of 1 fall per year for these 17 people alone would result • in a cost saving of £21,000 per year for the local health and care economy All reported feeling safer and more confident around the home • OADBY & WIGSTON CASE STUDY - BATHING ASSESSMENT & EQUIPMENT Start Date: 5.02.18 - End Date: 20.2.18 WHAT WERE THE MAIN ISSUES FOR THE INDIVIDUAL? ( E.G. IDENTIFIED BY THE MOT CHECKLIST) SU has recently had a series of mini strokes and has been staying at daughters home, since leaving hospital. The SU wishes to return home and be more independent. The SU also suffers with arthritis and swelling in his left arm and has double vision at times, causing issues with bathing transfers, bed transfers and toilet access and transfers. WHAT ACTIONS WERE TAKEN? Visit and MOT completed and assessed for a wooden half step and grab rails for the front door, also a metal rail along the front path which leads to the front door. Bath lift provided to assist with bathing transfers and a bed lever. Equipment also provided for toilet. WHO ELSE WAS INVOLVED Advice given on contacting adult social care for support with some care when SU returns home. The adaptations have meant that the risk of falls is reduced and this SU can return home to live life as independently as possible, with additional care where needed. Full Council | Tuesday, 02 October 2018 5
OWBC Lightbulb Presentation (October 2018) 02/10/2018 Housing Support Co-Ordinators Performance The chart below shows for all districts:- The time take for a case to be referred to lightbulb, to being picked up for a housing • MOT by a HSC (blue) The time taken for a HSC to process the case and close it (red). OWBC is on par with • the average for all districts here Qtr 1 2018 - Average times for HSC's (days) 70 Avge Ref to MOT Time 60 (days) 50 40 30 MOT to case closed (days) 20 10 0 Average of all districts Blaby Charnwood H&B Harb Melton NWL O&W (Case open to closed time in days) Evidence of outcomes – OWBC Disabled Pre-Lightbulb Post -Lightbulb Facilities Grant type Number Average Number Average No. Days No. Days Level Access Shower 17 264.86 28 219.80 improved Stair lift 3 239.50 11 128.00 improved Other 3 433.00 12 106.00 improved Total 23 51 Full Council | Tuesday, 02 October 2018 6
OWBC Lightbulb Presentation (October 2018) 02/10/2018 Lightbulb Service Costs Blaby, 47,541 Charnwood, 95,082 Harborough, Leicestershire 36,570 County Council, Hinckley & 365,700 Bosworth, 65,826 Melton, North West 32,913 Leicestershire, Oadby & 54,855 Wigston, 32,913 HOSPITAL HOUSING ENABLER TEAM Central part of Lightbulb Offer • Targeted to a key Better Care Fund aim and metric e.g. delayed transfers of care • Housing Enablers & Community Support workers based in hospital settings, both • acute and mental health Quickly established as essential members of integrated discharge team • Seek a wide variety of innovative and pragmatic housing solutions • Access to budgets to help with rent deposits & furniture • Formal evaluation using PI care and Health data and simulation modelling • Links with wider Lightbulb offer and Housing Support Coordinator role • Excellent results! • Full Council | Tuesday, 02 October 2018 7
OWBC Lightbulb Presentation (October 2018) 02/10/2018 Evidence of outcomes – Hospital Housing Enabler • 411 cases have been dealt with by the team up to the 31.12.17 • Reasons for referrals –homelessness/home no longer suitable/family refusing return • High demand for clean & clear budget UHL service three months post intervention analysis on 357 patients saw: • - 57% reduction in A&E attendances • - 54%reduction in A&E admissions • - 27% increase in no activity • - 84% reduction in NHS costs for this cohort of patients 3 months post intervention – saving £222,000, scaled up this could mean a potential £550,000 saved over 12 months Evidence of outcomes – Hospital Housing Enabler 115 patients at the Bradgate Unit analysed saw : • 920 delayed bed days saved • Of 40 service users who continued to receive support in the community following discharge only one was readmitted • Over 12 months the projected housing DTOC costs would be £175,000 compared to £650,000; a potential reduction of £475,000 • Referrals to the Bradgate Unit have risen by 67% in last 6 months. In contrast resolution times have reduced by 60% meaning despite the rise in referral patients are receiving a speedier service reducing the chance of delays Full Council | Tuesday, 02 October 2018 8
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